Observational analysis of clinical and pathological characteristics and their prognostic impact in Mexican patients with breast cancer: A multi-center study.

Breast cancer is the most incidental and deadly neoplasm worldwide; in Mexico, very few epidemiologic reports have analyzed the pathological features and its impact on their clinical outcome. Here, we studied the relation between pathological features and the clinical presentation at diagnosis and their impact on the overall and progression-free survival of patients with breast cancer. For this purpose, we collected 199 clinical records of female patients, aged at least 18 years old (y/o), with breast cancer diagnosis confirmed by biopsy. We excluded patients with incomplete or conflicting clinical records. Afterward, we performed an analysis of overall and progression-free survival and associated risks. Our results showed an average age at diagnosis of 52 y/o (24-85), the most common features were: upper outer quadrant tumor (32%), invasive ductal carcinoma (76.8%), moderately differentiated (44.3%), early clinical stages (40.8%), asymptomatic patients (47.8%), luminal A subtype (47.8%). Median overall survival was not reached, but median progression-free survival was 32.2 months (29.75-34.64, CI 95%) associated risk were: clinical stage (p < 0.0001) symptomatic presentation (p = 0.009) and histologic grade (p = 0.02). Therefore, we concluded that symptom presence at diagnosis impacts progression-free survival, and palpable symptoms are related to an increased risk for mortality.

Analisis del impacto de la pandemia por covid-19 en recursos de rehabilitacion psicosocial / Analysis of the impact of the covid-19 pandemic on psychosocial rehabilitation resources

Como se ha podido comprobar, la irrupción de una pandemia como la generada por el COVID-19, así como, las consiguientes restricciones, afectan en mayor medida a los grupos más vulnerables como, entre otros, son las personas con Trastorno Mental Grave (TMG). Los objetivos fundamentales de este estudio pasan por analizar y comparar con la población general a la que pertenecen, el porcentaje de infecciones, hospitalizaciones y fallecimientos relacionados con el COVID-19 en el caso de recursos destinados a la atención a personas con TMG, como son los gestionados por la Línea de Rehabilitación Psicosocial (LRHP) de la organización Hermanas Hospitalarias. A su vez, también se analizan y comparan con periodos previos otras variables que han podido verse afectadas en esta crisis sanitaria tales como ingresos psiquiátricos, abandono de los recursos, intentos autolíticos o suicidios consumados. A diferencia de lo encontrado en la literatura previa, los resultados indican que no existen diferencias estadísticamente significativas entre los porcentajes de infecciones, hospitalizaciones o fallecimientos por COVID-19 entre la LRHP y los registrados en la población general. En cuanto a variables relacionadas con la Salud Mental, se encuentran diferencias estadísticamente significativas entre el año 2020 y el anterior, en el porcentaje de ingresos psiquiátricos y abandono en los recursos ambulatorios, siendo estos menores en 2020. Sin embargo, en el caso de los recursos residenciales, se registra un porcentaje significativamente mayor en el porcentaje de abandonos en 2020. Dichos resultados han de ser tomados con cautela, puesto que existen múltiples limitaciones que pudieran estar afectando a los mismos y pueden ser interpretados teniendo en cuenta los cambios contextuales relacionados con la pandemia respecto al funcionamiento de los recursos hospitalarios o a las restricciones a nivel de movilidad (AU)

As has been seen, the outbreak of a pandemic such as that generated by COVID-19, as well as the consequent restrictions, affect to a greater extent the most vulnerable groups such as, among others, people with Severe Mental Disorder (SMD). The fundamental objectives of this study are to analyze and compare with the general population to which they belong, the percentage of infections, hospitalizations and deaths related to COVID-19 in the case of resources destined to the care of people with TMG, such as those managed by the Linea de Rehabilitacion Psicosocial (LRHP) of the Sisters Hospitallers organization. At the same time, other variables that have been affected in this health crisis such as psychiatric admissions, abandonment of resources, autolytic attempts or completed suicides are also analyzed and compared with previous periods. Unlike what was found in the previous literature, the results indicate that there are no statistically significant differences between the percentages of infections, hospitalizations or deaths from COVID-19 between the LRHP and those registered in the general population. As for variables related to Mental Health, there are statistically significant differences between 2020 and the previous year, in the percentage of psychiatric admissions and abandonment in outpatient resources, these being lower in 2020. However, in the case of residential resources, there is a significantly higher percentage of abandonments in 2020. These results must be taken with caution, since there are multiple limitations that could be affecting them and can be interpreted taking into account the contextual changes related to the pandemic regarding the functioning of hospital resources or restrictions at the level of mobility (AU)

Analisis de la satisfaccion con los servicios prestados y la calidad de vida subjetiva durante la pandemia por covid-19 en recursos de rehabilitacion psicosocial / Analysis of satisfaction with services borrowed and subjective quality of life during the covid-19 pandemic in resources of psychosocial rehabilitation

El primer obetivo del presente estudio pasó por analizar los valores medios y ver las posibles diferencias entre la puntuación total y los tres factores que integran una escala de valoración acerca de la satisfacción con los servicios prestados, creada ad hoc para el mismo y que cuenta con una versión para recursos diurnos y otra para recursos residenciales, habiendo de hacerse la valoración de los ítems que la componen tanto durante el periodo de confinamiento por COVID-19 como durante la adaptación a la nueva normalidad. Por su parte, el segundo objetivo tuvo que ver con el análisis de los valores medios en calidad de vida subjetiva, valiéndose de una escala validada para población con Trastorno Mental Grave, tras la declaración de la pandemia en 2020 y comparar los mismos con los obtenidos en el año anterior. Dichos cuestionarios fueron aplicados entre los meses de diciembre y enero de 2020 a todos los usuarios de recursos diurnos y residenciales de la Línea de Rehabilitación Psicosocial de la entidad Hermanas Hospitalarias que cumplieran con los criterios de inclusión. Tras la recogida de datos y posteriores análisis, se encuentra que la valoración media en cuanto a la satisfacción con los servicios prestados está en torno al 6, lo que correspondería a “bastante satisfecho”, en el caso de la puntuación total y de los tres factores, tanto en recursos residenciales como diurnos. Si bien, solo se localizan diferencias estadísticamente significativas en el caso de los recursos diurnos entre el periodo de confinamiento y adaptación a la nueva normalidad, algo que ocurre en la puntuación total y en dos de los tres factores (AU)

The first objective of this study was to analyze the average values and see the possible differences between the total score and the three factors that make up a rating scale about satisfaction with the services provided, created ad hoc for it and that has a version for day resources and another for residential resources, having to make the assessment of the items that compose it both during the period of confinement by COVID-19 and during the adaptation to the new normal. For its part, the second objective had to do with the analysis of the average values as subjective quality of life, using a validated scale for population with Severe Mental Disorder, after the declaration of the pandemic in 2020 and compare them with those obtained in the previous year. These questionnaires were applied between the months of December and January 2020 to all users of day and residential resources of the Línea de Rehabilitación Psicosocial of the entity Hermanas Hospitalarias who met the inclusion criteria. After the collection of data and subsequent analysis, it is found that the average assessment in terms of satisfaction with the services provided is around 6, which would correspond to "quite satisfied", in the case of the total score and the three factors, both in residential and day resources (AU)

Mental health professionals' attitudes towards mental illness: professional and cultural factors in the INTER NOS study.

BACKGROUND: Research shows that personnel working in mental health facilities may share some of the societal prejudices towards mental illness. This might result in stigmatizing behaviours towards people suffering from mental disorders, undermining the quality of their care. AIMS: To describe and compare attitudes towards mental illness across a sample of professionals working in a wide range of mental health facilities in Spain, Portugal and Italy. METHOD: We administered a survey to personnel including two questionnaires related to stigmatizing attitudes: The Community Attitudes toward the Mentally Ill (CAMI) and the Attribution Questionnaire (AQ-27). Data were compared according to professional category, work setting and country. RESULTS: 34.06% (1525) professionals of the surveyed population responded adequately. Psychologists and social therapists had the most positive attitudes, and nursing assistants the most negative, on most factors of CAMI and AQ-27. Community staff had more positive attitudes than hospital-based professionals in most factors on CAMI and in discriminatory responses on AQ-27. CONCLUSIONS: Globally, mental health professionals showed a positive attitude towards mental illness, but also a relative support to coercive treatments. There are differences in attitudes modulated by professional category and setting. Results can guide preventive strategies, particularly for the hospital-based and nursing staff.

Buscando la reconstrucción personal, retomando el control de la propia vida (Un diseño para favorecer procesos de "recovery" y "empowerment") / No disponible

This article describes a program called «Personal Recovery», initiated at Miniresidence in Aravaca in 2002. Its goals for the persona are: taking back his internal control feelings, implication in the rehabilitation process, and gaining skills to remake a satisfactory life and adjusted to the reality. An adapted design of this program, called «Personal Planification group», is shown, as a effort to generalize the benefits of the «personal recovery program» to extended groups (AU)

El siguiente artículo recoge, en una primera parte, una descripción de la experiencia práctica sobre un programa denominado «Reconstrucción personal» que se inició en el año 2002 en la Mini-Residencia de Aravaca. Se destacan los objetivos con los que se diseñó y que consistían en favorecer que la persona retomara el sentimiento de control interno sobre su vida, fomentar que se implicara en su proceso de rehabilitación y potenciar la adquisición de estrategias que le permitieran reconstruir su propia vida de manera satisfactoria y ajustada a su situación real. En una segunda parte se expone un diseño adaptado de dicho programa, que se denominó «Grupo de Planificación personal», así como una serie de planteamientos metodológicos para el funcionamiento general, derivados de las reflexiones y esfuerzos por generalizar los beneficios del «Programa de reconstrucción personal» al mayor número posible de las personas que acceden a diferentes recursos de rehabilitación psicosocial (AU)